电阻抗断层显像导向呼气末正压滴定对急性呼吸窘迫综合征患者影响的Meta分析

doi:10.3761/j.issn.2096-7446.2026.11.018

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (11): 1384-1390.doi: 10.3761/j.issn.2096-7446.2026.11.018

电阻抗断层显像导向呼气末正压滴定对急性呼吸窘迫综合征患者影响的Meta分析

王瑞¹(), 尹瑞元², 李伟伟², 张瑞娜², 朱磊², 付晓燕³, 岳伟岗²^,^*()

¹ 兰州大学第一医院重症医学科二病区兰州市 730000
² 兰州大学第一医院重症医学科一病区兰州市 730000
³ 兰州大学第一医院护理部兰州市 730000

收稿日期:2025-12-03 出版日期:2026-11-10 发布日期:2026-11-06
通讯作者: *岳伟岗，E-mail：yueweigang5963@163.com
作者简介:王瑞：女，硕士，护师，E-mail：15117167515@163.com
作者贡献声明
王瑞、张瑞娜：文献检索、质量分析、论文撰写；尹瑞元、李伟伟：数据整理、统计学分析；朱磊、付晓燕：研究指导、经费支持；岳伟岗：论文修改
基金资助:
甘肃省卫生健康行业科研计划项目(GSWSHL2020-25)

A meta-analysis of the impact of electrical impedance tomography-guided positive end-expiratory pressure titration on patients with acute respiratory distress syndrome

WANG Rui¹(), YIN Ruiyuan², LI Weiwei², ZHANG Ruina², ZHU Lei², FU Xiaoyan³, YUE Weigang²^,^*()

¹ Second Ward of the Intensive Care Unit， the First Hospital of Lanzhou University， Lanzhou 730000， China
² First ward of the Intensive Care Unit， the First Hospital of Lanzhou University， Lanzhou 730000， China
³ Nursing Depart-ment， the First Hospital of Lanzhou University， Lanzhou 730000， China.

Received:2025-12-03 Online:2026-11-10 Published:2026-11-06
Contact: *YUE Weigang，E-mail：yueweigang5963@163.com
Supported by:
Gansu Provincial Health and Wellness Industry Research Project(GSWSHL2020-25)

摘要/Abstract

摘要：

目的评价电阻抗断层显像技术（electrical impedance tomography，EIT）导向呼气末正压（positive end-expi-ratory pressure，PEEP）滴定对急性呼吸窘迫综合征（acute respiratory distress syndrome，ARDS）患者的影响。方法系统检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、维普数据库及万方数据库中，有关EIT导向PEEP滴定治疗ARDS的相关临床文献，检索时限设定为各数据库建库至2025年11月1日。由2名研究者严格遵循Cochrane系统评价标准，独立完成文献质量评定与数据提取工作，并运用RevMan 5.3软件开展统计学Meta分析。结果最终筛选出17项符合纳入标准的临床研究，累计纳入649例ARDS患者。Meta分析结果显示，相较于传统的PEEP设定方法，对ARDS患者使用EIT导向PEEP滴定后，患者肺顺应性改善（P<0.001），患者病死率降低（P=0.02），但PEEP值（P=0.25）、氧合指数（P=0.44）、平均动脉压（P=0.72）及住院时间（P=0.05）等指标，二者差异均无统计学意义。结论相较于传统PEEP通气设置方式，基于EIT个体化滴定的通气方案可有效优化ARDS患者肺部顺应性，并降低临床死亡风险，但对于PEEP值、患者的氧合指数、平均动脉压和住院时间均无影响。

关键词: 电阻抗断层显像, 呼气末正压, 呼吸窘迫综合征, 急性呼吸衰竭, Meta分析

Abstract:

Objective To evaluate the effect of electrical impedance tomography（EIT） guided positive end-expiratory pressure（PEEP） titration on patients with acute respiratory distress syndrome（ARDS）. Methods Relevant studies on the impact of EIT-guided PEEP titration on patients with ARDS were retrieved from Pubmed，Embase，Web of Science，the Cochrane Library，CNKI，VIP，and Wanfang Chinese databases. The search period covered the period from the establishment of the database to November 1，2025. Two researchers independently evaluated the quality of the included studies and extracted the data according to the Cochrane systematic review method. Meta-analysis was performed using RevMan 5.3 software. Results A total of 17 clinical studies meeting the criteria were included，involving 649 patients. The meta-analysis results showed that compared with the traditional PEEP setting method，after using EIT-guided PEEP titration for patients with ARDS，the lung compliance of patients significantly improved（P<0.001），the mortality rate of patients significantly decreased（P=0.02）. But there were no statistically significant differences in PEEP values（P=0.25），oxygenation index（P=0.44），mean arterial pressure（P=0.72），and hospital stay（P=0.05） between the two groups. Conclusion Compared with the traditional PEEP setting me-thod，EIT can improve the lung compliance of patients and reduce the mortality rate of patients，but it has no effect on PEEP values，oxygenation index，mean arterial pressure，and hospital stay.

Key words: Electrical Impedance Tomography, Positive End-Expiratory Pressure, Respiratory Distress Syndrome, Acute Respiratory Failure, Meta-Analysis

王瑞, 尹瑞元, 李伟伟, 张瑞娜, 朱磊, 付晓燕, 岳伟岗. 电阻抗断层显像导向呼气末正压滴定对急性呼吸窘迫综合征患者影响的Meta分析[J]. 中华急危重症护理杂志, 2026, 7(11): 1384-1390.

WANG Rui, YIN Ruiyuan, LI Weiwei, ZHANG Ruina, ZHU Lei, FU Xiaoyan, YUE Weigang. A meta-analysis of the impact of electrical impedance tomography-guided positive end-expiratory pressure titration on patients with acute respiratory distress syndrome[J]. Chinese Journal of Emergency and Critical Care Nursing, 2026, 7(11): 1384-1390.

图/表 4

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电阻抗断层显像导向呼气末正压滴定对急性呼吸窘迫综合征患者影响的Meta分析

A meta-analysis of the impact of electrical impedance tomography-guided positive end-expiratory pressure titration on patients with acute respiratory distress syndrome

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